Registration Form | Fred Finch

First Name

Last Name

Email

Select the location where you provide services or support for system-involved youth and their families:

Alameda

Amador

Calaveras

Contra Costa

Humboldt

Lake

Mendocino

Solano

Tuolumne

Fred Finch Staff

Name (do NOT use acronym) of agency or organization (Enter N/A for Caregiver/Family Resource or Private Practitioner):

For staff employed by Alameda County (AC), please enter your AC Staff ID Number

Are you a parent/caregiver of a child in the foster care system (including foster, adoptive, or kinship caregivers)?

Yes

No

Please mark below which best describes your role:

Service Provider Agency Staff

Social Service Agency (AC Staff Only)

Caregiver/Family Resource

Other

Please indicate if you need proof of attendance by selecting one of the following:

N/A

CE Hours

Certificate of Attendance

If you need CE Hours for this course, enter your license type and number:

Register for this Fred Finch Training